Provider Demographics
NPI:1629941505
Name:GARCIA, KENISHA YVETTE
Entity type:Individual
Prefix:
First Name:KENISHA
Middle Name:YVETTE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 N ARGONNE RD
Mailing Address - Street 2:
Mailing Address - City:MILLWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2305
Mailing Address - Country:US
Mailing Address - Phone:509-892-1637
Mailing Address - Fax:
Practice Address - Street 1:2702 N ARGONNE RD
Practice Address - Street 2:
Practice Address - City:MILLWOOD
Practice Address - State:WA
Practice Address - Zip Code:99212-2305
Practice Address - Country:US
Practice Address - Phone:509-892-1637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61586959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist